Executive Director, Payer Contracting - Retail Health

CVS Health • Woonsocket, RI

7d

About The Position

The Executive Director, Payer Contracting leads payer contracting strategy for Retail Health, overseeing contract negotiations, payer relationships, financial performance, and contract execution. The role develops and advances payer strategies that support business growth, patient access, and sustainable financial performance while aligning contractual arrangements with clinical and operational needs.

The Executive Director serves as a strategic partner to Finance, Legal, Operations, Revenue Cycle, Clinical, Compliance, and other enterprise stakeholders, bringing together payer strategy, financial insight, and operational execution. The position also leads and develops the payer contracting team and advises senior leadership on strategy, opportunities, risks, and performance.

Requirements

• 15 or more years of progressive healthcare experience, including significant experience in payer or managed care contracting.
• Demonstrated success developing payer strategies, leading complex healthcare contract negotiations, and managing senior-level payer relationships.
• Strong understanding of healthcare reimbursement models, contract economics, payer-provider relationships, and contract performance.
• Strong financial and analytical acumen, including the ability to evaluate the business implications of complex contractual arrangements.
• Exceptional negotiation, executive communication, relationship management, and influencing skills.
• Ability to lead across a complex, highly matrixed healthcare organization and align diverse stakeholders.
• Experience leading and developing high-performing teams.
• Bachelor’s degree required.

Nice To Haves

• Deep experience with national and regional health plans and government and commercial payer contracting, particularly in ambulatory, physician, or retail health environments.
• Advanced degree.

Responsibilities

• Develop and execute payer contracting strategies aligned with Retail Health priorities, growth objectives, and evolving care delivery models.
• Assess payer, reimbursement, and healthcare market trends and translate their implications into contracting strategies and recommendations.
• Advise senior leadership on payer strategy, contracting opportunities, risks, and performance.
• Lead and develop the payer contracting team, setting priorities, accountability, and consistent contracting practices.
• Lead complex negotiations, renewals, amendments, and strategic contract discussions with national and regional health plans.
• Build and maintain senior-level payer relationships and identify opportunities to strengthen and expand partnerships.
• Evaluate reimbursement terms, contract economics, financial opportunities, and risks to inform negotiations and business decisions.
• Oversee the payer contract portfolio and establish priorities to ensure contracts meet financial, operational, and strategic objectives.
• Monitor contract performance and identify opportunities to improve reimbursement, contract value, and overall performance.
• Partner with Finance, Legal, Revenue Cycle, Operations, Clinical, and Compliance on contract development, implementation, and ongoing execution.
• Lead resolution of significant payer contracting issues, disputes, and escalations.

Benefits

• CVS Health bonus, commission, or short-term incentive program eligibility.
• Award target in the company’s equity award program.
• Medical coverage.
• Dental coverage.
• Vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive